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Is Increasing Concussion Awareness Changing The Game Of Soccer?

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School is back in session and students are back on the playing fields during a time of increasing concerns over concussions. In the second part of a two-part series, WAMC reports on an often-overlooked sport when it comes to head injuries.The 20 members of the Mt. Greylock varsity girls’ soccer team prepared themselves for the fall season during a recent practice. But some of them may have more on their minds than wins and losses. Freshman goalkeeper Tenley Smith is one of four players who’ve suffered a concussion, some more than one.

“I went to catch a ball and it went right through my hands and hit me square in the face. I fell over and went ‘Ouch.’ So I basically decided that I really never wanted that to happen again. So yeah, I’d say I’m worried about it.”

Although soccer is not often thought of as a contact sport, more than 29,000 concussions were suffered by female high school soccer players from 2005 to 2006, according to a national study cited by the Centers for Disease Control and Prevention. The total was second only to high school football with 55,000.  Active in soccer since the late 1980s, Tom Ostheimer is entering his eighth season as coach of the Mounties.

“I think we are on sort of a tipping point here in terms of how we’re going to deal with the high rates of concussions,” said Ostheimer.

Dr. Sheralee Tershner chairs the Neuroscience Department at Western New England University. She says the national conversation about the effect of concussions suffered while playing sports, highlighted by lawsuits involving the NFL, is driving research, much like what high-speed crashes have done for vehicle safety.

“We know that when there’s trauma to the brain, and usually it’s a one shot deal, an acute trauma, say when your child falls of their bike or something like that,” Tershner said. “That’s entirely different than what we’re seeing with the concussions in sports because that’s chronic exposure. The kids will get multiple concussions. That’s why we don’t know the answers to these questions, because that’s a different ballgame.”

Since 2009, all 50 states have passed some form of concussion law requiring athletes, coaches and parents go through concussion training along with mandatory removal from a game or practice and medical clearance to return if a head injury is suspected. But Tershner says when humans are in a stressful situation such as athletic competition, the body releases endorphins as a defense mechanism.

“Which will inhibit pain,” Tershner explained. “So while you’re engaging in the sport it’s not the best time to try to realize whether it’s hurting you or not.”

At Mt. Greylock, athletes and their parents are required to take the National Federation of State High School Associations' concussion course. Ostheimer explains his players also take a cognitive test during the preseason to provide a baseline of data if a player suffers a head injury later.

“Then they have that in terms of gauging how soon the player can come back who’s got concussion symptoms,” Ostheimer said. “Then they retake the test. However they score, they either get the green light. So in one respect, from a coach’s standpoint it could expedite a kid getting back onto the field by taking that impact test. If there’s no information you only have the symptoms to go by.”

Tershner says baseline testing represents important progress in studying brain injuries, but the results can be tricky especially in young people whose brains continue to develop into their early 20s.

“So the baselines are going to be different just by default and you’re going to be using these baselines as a comparative index to maybe a state of the brain that’s been damaged.”

Senior defender Lucy Barrett suffered a concussion two years ago when she collided with another player jumping for a head ball.

“I think they’re now starting to worry kids and have kids play more hesitant because there is worry that there’s always things like ‘You’re never going to be the same and you’re not going to be able to do sports ever again if you get a bad enough concussion and you should be cautious about it.’ But it’s getting to the point where girls are going in and playing more hesitant and not to their full potential.”

The report cited by the CDC found that a female is more likely to suffer a concussion than a male when heading the ball. Tershner says there’s no neurological reason for that, but her educated guess is that the male neck and shoulders are typically larger and better able to absorb the shock of the ball. Ostheimer explains the proper way to head the ball is to tense up and essentially make your head a hammer.

“You want to strike the ball, you don’t want the ball striking you,” Ostheimer demonstrated. “So a lot of times when concussions happen it’s not an intentional head ball because with an intentional head ball you see the ball coming. You want to hit it off your forehead above your brow, not off the top of the head.”

As a brain researcher and mother of an 8-year-old daughter who plays soccer, Tershner says she cringes at the thought of players practicing the art of heading the ball, especially at a young age — and in fact, many early youth leagues won’t practice headers at all.  

“Also just to think that’s it’s OK, that’s what scares me,” Tershner said. “It’s not OK to fall off your tricycle, but it’s OK to hit a moving target with your head.”

Ostheimer requires any player who has suffered a concussion to wear head gear made for soccer that looks like a thick headband, which costs about $50. There is also equipment that costs about $150 covering the entire head with sensors to track impact.

For some players, like senior forward Kelsey Orpin, who also has had a concussion, the changes can be overwhelming.

“I don’t think we’re getting enough knowledge about it when we’re younger and then once we hit high school they’re just throwing all of this information at you that you have no idea about,” said Orpin.

The Brain Injury Association of Massachusetts provides information and resources on the risks of concussions along with treatment and prevention of head injuries including school outreach programs. Executive Director Nicole Godaire says the agency has been receiving more calls from individuals and professionals seeking information over the past 10 years, something she attributes to increased media attention on head injuries.

“So I think one of the things that has really happened over the last couple is that coaches, athletes, parents and the public are making sure that children are being safe and that they’re taking the appropriate steps to make sure that they can continue to play sports in the long-term future and to live a quality life,” said Godaire.

Ostheimer says he will continue to advocate for headgear for all players, believing the school isn’t too far off from mandating it. He says over the past five years, he has seen a decline in head balls.

“As coaches we need to be responsible,” he said. “I think we also need to model being cautious. Winning is never more important than the health of a player.”

Though the requirements and testing may seem extreme, players like Barrett realize the dangers.

“If you hit it again then you’re going to be out for so long and you could possibly not play sports again,” Barrett said.  “It’s worth that shorter time of waiting than the long time of possibly even having it carry on through the rest of your life.”

Click here for the first story in this two-part series on concussions in youth sports.

Jim is WAMC’s Associate News Director and hosts WAMC's flagship news programs: Midday Magazine, Northeast Report and Northeast Report Late Edition. Email: jlevulis@wamc.org
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